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The Consequences of Surviving

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PTSD is defined as an anxiety disorder caused by a traumatic event, or stressor, such as a natural disaster. A life-threatening illness is only considered a stressor if it involves a ‘sudden, catastrophic event’ such as waking up during surgery.

In this article for Aeon Liza Gross explores an argument put forward by Phil Wolfson, a psychiatrist in Marin County, that hearing the words “You’ve got cancer” is a catastrophic event in itself, and even when the tumors retreat, “that kind of fear stays with you.” Wolfson is campaigning for a new diagnosis: PTSD-life-threatening illness (PTSD-LTI) — to increase support both for the survivors of life-threatening illnesses, and for their carers.

Although a diagnosis can bring benefits, Cole says, ‘you are in a state of anxiety at all times.’ He can’t shake the thought that any aches and pains, normal for his 67 years, might be new signs of his body’s betrayal. Today, he practises palliative care at a hospice. He knows the patients are probably floating in space, too, needing specialised care to manage their distress.

He believes no one should leave an oncologist’s office with a cancer diagnosis without a referral to someone trained to manage the anxiety and trauma that inevitably shadows the course of treatment. But that’s not what happens. ‘As medicine advances, we have more survivors,’ Cole says. ‘That’s a good thing. But those survivors carry trauma to their graves, and we haven’t recognised that it’s a disease process that needs treatment.’

Wolfson is also an advocate for using ketamine and MDMA in the treatment of those suffering from this form of PTSD.

Therapists have long known that MDMA, outlawed in 1985 as having no medical use and a high potential for abuse, melts defences and eases anxieties while boosting mood and trust – key ingredients for successful therapy. The drug works partly by dissipating the crippling fear that prevents people from revisiting a trauma, a necessary step in learning how to live with it. ‘It opens the doors of the heart and removes some of the blocks to feeling and suppression,’ Wolfson says, making it easier to tolerate deeply distressing memories and emotions.

Feeling unburdened, Wolfson’s patients were willing to plumb the depths of their psychic pain in profound ways, looking at how the disease disrupted their lives, self-worth, and personal and professional interactions. Their ability to confront their worst fears helped Wolfson chart a therapeutic path to ease their suffering and anxiety.

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Is the Weekly Shop Good For You?

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Grocery stores around the world are in a race to bring food shopping into the digital era — the Food Marketing Institute predicts that 70 percent of US consumers will be getting at least some of their groceries online within the next four years. As Corey Mintz writes for The Walrus, what is less clear is what ripple effects this will have on “our daily lives, our communities, our health, and our workforces.” 

My local grocer, Potsothy “Pots” Sallapa, upon hearing of my engagement, insisted that we hold the wedding in his shop. My fiancée thought it sounded crazy at first—I remember her saying something about not wanting our photos to feature a stack of ­cereal boxes. But the store was a cozy place and near the apartment we shared at the time, and she agreed to at least give it a look with fresh eyes. As we toured the high-ceilinged, wood-beamed store, among Saturday-morning crowds stocking up on grapes and granola, I could see on her face that this wasn’t just a place people went to acquire toilet paper: it was a community hub. A few months later, we walked down the store’s central aisle and got married between the cash register, the root-vegetable table, a group of our friends and family, and a display of maple syrup.

There is something fundamentally important about analog shopping — getting out of the house, choosing what you want to purchase, finding new things to buy and “even the game of choosing the right checkout aisle, the one with the fastest cashier.”

One problem with all this progress is that, while other human beings can be annoying—clipping our nails on the subway, calling instead of texting, disrespecting the unwritten rule that the middle seat on a plane gets armrest preference—we need one another. Research suggests that even low-level social interactions—the kinds we have with our neighbours and mail carriers and local storeowners—form bonds known as “weak ties.” These connections have been shown to improve physical and mental health and to help reduce loneliness. “Even social interactions with the more peripheral members of our social networks contribute to our well-being,” concludes one 2014 study of weak ties—an important finding as rates of self-reported loneliness grow. More than a third of Americans over forty-five feel lonely, a 2018 study found. While some of this has been attributed to changing family dynamics (we get married later and less often than we used to, and we have fewer children), casual opportunities for social interaction, like those found when buying food, are a part of preventing isolation as well.

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Detective Fitbit

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The personal activity-tracking device, Fitbit, has become increasingly popular since it was first released in 2009. It was therefore only a matter of time until one would be worn by victims or suspects of crimes — and potentially be the key to finding out what had actually occurred. As Lauren Smiley explains for Wired, people are inadvertently wearing “a sort of black box for the body that reveals physiological truths that its wearer might prefer to conceal.”

At 90 years old, Tony Aiello was arrested for the murder of his stepdaughter, Karen Navarra. On the day of her death, Tony dropped by her house with a surprise treat of biscotti and pizza. He claimed she was alive when he left. Her Fitbit told a different story.

At a San Jose police station, Tony was hauled into a homicide interrogation room. “What the hell am I doing here?” he asked detectives Brian Meeker and Mike Montonye. Then he waived his right to remain silent and amiably rattled off his life history and answered questions about Karen, until one detective abruptly shifted the subject: Did Tony know what a Fitbit was? He shook his head. They told him that it was a watch with a step counter built into it. “Oh, nice,” Tony marveled, not seeing where the questioning was going. It also has a heart rate monitor, they said. “Oh, that’s better yet.”

The detectives continued: The data shows that Karen’s heart stopped at 3:28 pm, they told Tony. What’s more, they knew Tony was there at the time.

“Oh, no,” Tony said. “She was alive when I left.”

Should we be using Fitbit information in court cases? There are still no set legal standards for how and when this new type of data should be admitted. There are also no guarantees it can be relied on.

Smartwatches decipher heart rate using green LEDs that beam hundreds of times per second into capillaries through the skin. Those capillaries allow in more of the light when full of blood, and less between beats, and the device measures how much light is absorbed. That measurement is then siphoned through a proprietary algorithm to generate a heart rate figure. University of Wisconsin researchers looked at how well wrist-worn fitness trackers measured heart rate, comparing it to an electrocardiograph, the gold standard for heart monitoring. They found that the fitness trackers’ heart rate deviated more from the actual rate when a subject exercised on a treadmill than when at rest. (Fitbit won’t talk specifics about its accuracy, saying in a statement, “We are confident in the performance of all our devices” and that the company continues to test them.)

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Making Periods Green To Topple Tampax

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With 4.5 billion boxes of Tampax sold worldwide last year, the brand is so well known, it’s almost a synonym for tampons. But recently some up and comers have been trying to edge the giant out of the lucrative period market. As  Sophie Elmhirst writes for The Guardian “the common strategy is to offer more ethical and ecological options to replace Tampax’s simple single-use plastic applicators and a marketing strategy that often emphasizes discretion, as though a period should be something to hide.”

“You’ll love the Quiet Easy Reseal Wrapper,” goes the current marketing blurb for Tampax Radiant. As a narrative, it seems increasingly at odds with the times. Why should we hide tampons up our sleeves on the way to the bathroom, or worry that someone might hear us unwrap one once we’re there? (In a recent Saturday Night Live sketch, Phoebe Waller Bridge riffed on all the possible items – a copy of Mein Kampf, a neatly folded Confederate flag, a dog shit – within which you could more acceptably conceal a tampon and its associated deep shame.) 

Tampax has had to play catch-up. In such moments, multinationals can resemble the I’m-your-mate teacher with a tone-deaf enthusiasm for trends to which they are fatally late. (Women’s empowerment and period pride are in, you say? We’ll see you there, just after we’ve intensely focus-grouped the issue and come up with a hashtag.) 

As period startups multiply, so do the number of options, from organic cotton tampons, to absorbent pants, to a reusable applicator, to a “pain-relieving, CBD-infused, biodegradable cotton tampon.” Although the truth is a Swiss manufacturing firm called Ruggli has a near-monopoly on tampon-making machines, so almost every new tampon, is in fact, a  Ruggli tampon. 

The harsh reality remains that most startups will fail, and in order to have a chance against the global force that is Tampax, these new companies will have to diversify their products away from just the mighty tampon.

Many of the new brands look to the future of their customers, too, and the fact that they will not always have periods. The menopause approaches, another area of women’s health previously shrink-wrapped in shame but now becoming commercially ripe. Following the menstrual example, the menopause is now undergoing its own cultural rebranding. Multiple books have been written (The Good Menopause Guide, Confessions of a Menopausal Woman, Making Friends With the Menopause, and so on); Mariella Frostrup made a BBC documentary; Gwyneth Paltrow made a Goop video. “I don’t think we have in our society a great example of an aspirational menopausal woman,” said Paltrow, presumably nominating herself, the high priestess of expensive aspiration, for the job.

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Closing the Loop on Diabetes

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Writing for The Walrus, lifelong diabetic Jonathan Garfinkel explores a world where the hackers, not the scientists, are forging ahead with advances in diabetes management.

Monitoring Type One diabetes is a full-time job — a constant juggling act of how much insulin to take when blood glucose goes too high, and how much sugar to consume when it goes too low. A misjudgment means feeling terrible, slipping into a coma, or even dying. Essentially, a diabetic has to manually do the job normally performed by a pancreas — but some ingenious coding has created a shortcut on the road to creating an “artificial pancreas.”

“Artificial pancreas” isn’t a term I’d heard before. I ask Riddell to explain. “So, you have your insulin pump and your continuous glucose monitor,” he says. “Great technology. But these devices don’t talk to each other. You’re the one who’s still making the decisions. You have to interpret the numbers, analyze the trends, predict what you’ll be doing later in the day, and figure out how much insulin to take. What if a computer could do that for you?”

…a few years ago, a group of amateur coders, most of them type one themselves, were independently fiddling around with insulin pumps and CGM transmitters on their off hours, looking for ways to improve the devices. They eventually met, pooled their discoveries, and after a few more years of tinkering, created an iPhone program called Loop. It’s not available in the App Store or through any official channels—no doctors will prescribe it. Users need to find the instructions online and build the Loop app themselves. This bit of free code, Farnsworth tells me, paired with a hacked-together insulin pump and CGM, is an artificial pancreas.

“Is this legal?” I ask, imagining some dark alley where hooded hackers hand out instructions and tiny radios to desperate diabetics.

“Of course,” Farnsworth says, laughing. “It’s open-source software. It’s also a Facebook group. You can find everything you need online.”

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The Adaptation of Language Evolution


Your speech, or thine speech as Shakespeare would have said, has evolved with each generation that preceded you. The bubbling melting pot of language absorbs new influences with alacrity. Every time we repeatedly interact with people, we have the chance to develop a shared vocabulary. In The Walrus Gretchen McCulloch explores whether the language mix is changing faster as a result of technology. People interacting on social media often end up using similar phrases, yet we tend to follow others with the same interests, with words jumping around between demographically similar cities, regardless of geography. It’s not a surprise, therefore, that Twitter, where you’re encouraged to follow people you don’t already know, has given rise to the most linguistic innovation. And other factors, such as community and gender, are still playing a part.

Young women are also consistently on the bleeding edge of those linguistic changes that periodically sweep through media trend sections, from uptalk (the distinctive rising intonation at the end of sentences?) to the use of “like” to introduce a quotation (“And then I was like, ‘Innovation’”). The role that young women play as language disruptors is so clearly established at this point that it’s practically boring to linguists who study this topic: well-known sociolinguist William Labov estimated that women lead 90 percent of linguistic change in a paper he wrote in 1990. (I’ve attended more than a few talks at sociolinguistics conferences about a particular change in vowels or vocabulary, and it barely gets even a full sentence of explanation: “And here, as expected, we can see that the women are more advanced on this change than the men. Next slide.”) Men tend to follow a generation later: in other words, women tend to learn language from their peers; men learn it from their mothers.

McCulloch also delves into some innovative ways past linguists have studied language.

The fieldworker he selected was a grocer named Edmond Edmont, who reportedly had a particularly astute ear (it’s not clear whether this referred to the acuity of his hearing or his attention to phonetic detail, but either way, it got him the job). Gilliéron trained Edmont in phonetic notation and sent him off on a bicycle with a list of 1,500 questions, such as, “What do you call a cup?” and “How do you say the number fifty?” Over the next four years, Edmont cycled to 639 French villages, sending results back to Gilliéron periodically. In each village, he interviewed an older person who had lived in the region for their entire life, counting them as representative of the history of the area.

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The Misconception of the Wild


Leo Schwartz writes for Buzzfeed News about his romanticized notion of spending a summer in the Oregon backcountry. A fresh graduate, complete with an air of self-importance, he set off from New York for the grandeur of the American West for a period of introspection. Schwartz wanted to use the wilderness to satisfy something within himself:  it was a place to be used for his own purpose, an attitude prevalent in American society.

American conservation has a complicated past, rooted in the seizure of indigenous land for its administration by wealthy urbanites. Yosemite Valley, for example, lies next to the (formerly) equally stunning Hetch Hetchy valley, which was dammed, flooded, and converted into a reservoir in the early 20th century to serve the greater San Francisco Bay Area. Both valleys were inhabited by Native Americans before they were respectively turned into a playground and a wellspring.

Those who have access to the resources of federally owned forest land, both for recreational and agricultural purposes, are overwhelmingly white, and conflicts between government officials and land users — like the Bundys — are constant. 

For his time of reflection, Schwartz settled on a four-month volunteer program with the AmeriCorps.

…never mind the fact that my only real backpacking experience had involved puncturing several blisters borne of Walmart boots with a dull Swiss Army knife. I finally skimmed Walden. Now, I thought, the only thing separating me from bucolic bliss was high-quality footwear.

During the months of grueling labor, the wilderness began to take on a whole new meaning. No longer a place to find himself, it became instead somewhere to be respected, and, to be left alone.

The people of the Forest Service do this work not just because of a spiritual connection with nature, but because our world is burning. To begin to confront the impending end of the natural world, we have to redefine our relationship with land — and understand that it does not only exist for our own needs.

The United States has always viewed nature as a resource to be consumed or conserved. Wilderness, though, is not for us. Its purpose is to exist outside of our selfish motives. That summer, I was a steward for the wilderness of the Deschutes National Forest, but I was a visitor. It was not mine.

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The Reality of Being Sick and Alone


Diagnosed with aggressive breast cancer, Anne Boyer writes a searingly honest piece in The Guardian about the brutal nature of chemotherapy — a potential cure that is so poisonous it can destroy eyesight, speech, and memory. A treatment that also bears huge financial costs and a hidden environmental impact.

Someone once said that choosing chemotherapy is like choosing to jump off a building when someone is holding a gun to your head. You jump out of fear of death, or at least a fear of the painful and ugly version of death that is cancer, or you jump from a desire to live, even if that life will be for the rest of its duration a painful one.

My problem is that I wanted to live millions of dollars’ worth but could never then or now answer why I deserved the extravagance of this existence, why I consented to allow the marketplace to use as its bounty all of my profitable troubles. How many books, to pay back the world for my still existing, would I have to write?

Unceremoniously tipped out of the hospital and left to face the consequences of treatment, Boyer also confronts what cancer means if you don’t have a traditional family unit to offer you care.

It should be no surprise that single women with breast cancer, even adjusting for age, race and income, die of it at up to twice the rate of the married. The death rate gets higher if you are single and poor.

If you are loved outside the enclosure of family, the law doesn’t care how deeply – even with all the unofficialised love in the world enfolding you, if you need to be cared for by others, it must be in stolen slivers of time. As Cara and I sat in the skylit beige of the conference room waiting for the surgeon to arrive, Cara gave me the switchblade she carried in her purse so that I could hold on to it under the table. After all of those theatrical prerequisites, what the surgeon said was what we already knew: I had at least one cancerous tumour, 3.8cm, in my left breast. I handed Cara back her knife damp with sweat. She then went back to work.

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Is it Possible to be Child-Free and Content?

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Although an increasing number of women are choosing to remain childless, society still accepts motherhood as the “norm.” In a piece for The Walrus,  Lauren McKeon explains how she saw motherhood as a requirement, “a check mark on the way to an accomplished life,” until she eventually came to terms with wanting to be child-free.

I neared my thirties afraid to voice my dread. I worried that disclosing the main reason for my veer toward “no”—that I wanted to continue investing time in myself—would make me seem cold, even sociopathic. I worried about disappointing those around me, including my then husband, parents, and grandparents. I could already hear their disbelief. Even if they supported my choice, I worried about what I would do after I made it. How would I fill the next fifty—potentially empty—years of my life?

Even those unwaveringly confident in their choice can be overcome with doubt as they get older and start to mourn the loss of their fertility. This grieving can allow women to understand that while they don’t want children — they do “want something.” McKeon found a blossoming community of women dedicated to helping each other find fulfillment — while rejecting the need for procreation.  This is particularly important for a group that often receives pushback elsewhere: 

As the default structure for women’s lives, the motherhood imperative is a stand-in for order, an assurance that every woman is exactly who, and what, she is supposed to be. We live in an intense pro-maternity culture, one marked by everything from reality shows like Teen Mom OG to Kylie Jenner’s record-shattering February 2018 Instagram reveal of her newborn daughter, Stormi, which sits at 17.5 million likes (and counting). Even Hillary Clinton’s election team worked hard to frame her as, in husband Bill’s words, “the best mother in the whole world.”

Academics and activists call this mindset pronatalism. As Laura Carroll explains in The Baby Matrix, pronatalism is “the idea that parenthood and raising children should be the central focus of every person’s adult life.” Pronatalism is the reason the protagonist of the Hunger Games movie series earns motherhood as her reward for saving the world, and it is why, in real life, reporters recently asked one of the world’s first AI female robots where she stands on motherhood (surprise: she thinks having a family is “really important”). Pronatalism teaches women that children are synonymous with stability and that they are the answer to the question of life’s meaning. Motherhood, this mindset says, is more than a choice: it is a higher calling. To step outside of that path is not only inconceivable, it’s unnatural.

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